Organization
TEXAS RADIATION ONCOLOGY MEDICAL GROUP, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AJMEL A PUTHAWALA MD (MEDICAL DOCTOR)
(714) 962-1700
Entity
Organization
Contact information
Practice address
2800 STATE HWY 114 EAST, SUITE 100, TROPHY CLUB, TX 76262
(817) 693-0900
Mailing address
2865 E COAST HWY, 200, CORONA DEL MAR, CA 92625-2236
(949) 385-5012
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Enumeration date
09/19/2014
Last updated
01/09/2015
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